Antepartum

Question 1

Spotting with cramps & a closed cervix

+ fetal heartbeat

Answer 1

threatened abortion

Question 2

Moderate bleeding with cramping & a dilated cervix

Answer 2

Inevitable abortion

Question 3

Heavy or profuse bleeding with severe cramps & tissue present in cervix

Answer 3

incomplete abortion

Question 4

May have spotting or no bleeding, no cramping, cervix is closed, no fetal heartbeat present

Answer 4

Missed abortion

Question 5

What complication is common with poor glycemic control in early pregnancy?

Answer 5

Congential anomalies in fetus

Question 6

Preeclampsia develops when?

Answer 6

after 20 weeks gestation

Question 7

Preeclampsia & addition of

Answer 7

proteinuria greater than or equal to +1

transient headaches with irritability

Question 8

Preeclampsia without severe

Answer 8

greater 140 or greater than 90

protein urine greater than +1

Question 9

Preeclampsia with severe features

Answer 9

greater than 160 or greater than 110

Proteinuria not required*

Question 10

Preeclampsia: if multi systems involved

Answer 10

delivery must be performed

Question 11

Preeclampsia: if multi systems not involved yet:

Answer 11

improve blood flow
fetal oxygenation
bed rest
antihypertensive meds
anticonvulsant meds 
assess edema (tremendous weight gain)

Question 12

The placenta experiences ischemia because the spiral arteries of the uterus fail to reshape and increase in diameter

Answer 12

preeclampsia

Question 13

what to also check for with preeclampsia?

Answer 13

Increased DTR & Clonus

Question 14

Mag toxicity s/s

Answer 14

Depressed DTRs
Respiratory depression
oliguria <30 cc per hour

Question 15

therapeutic level of mag

Answer 15

4-7

Question 16

mag usually continues post partum why?

Answer 16

at least 24 hrs to prevent seizures

Question 17

Signs of recovery from preeclampsia

Answer 17

Urinary output 4-6 L
rapid weight loss
Decreased protein in urine
BP normal within 2 weeks

Question 18

what drug of choice for eclampsia

Answer 18

Mag Sulfate

Question 19

gestational HTN is different from preeclampsia bc

Answer 19

no protein in urine

no organ injury: liver, brain, kidney

Question 20

signs of impending seizures

Answer 20

Hyperreflexia
Clonus
Headache/visual disturbances
epigastric RUQ p!
Vomiting

Question 21

Risks for preeclampsia

Answer 21

Hx of
first pregnancy
diabetic, lupus, high BP
obese 
twins
age <18 or >35

Question 22

early pregnancy for diabetes & fuel metabolism

Answer 22

insulin response accelerates

hypoglycemia may occur

Question 23

late pregnancy for diabetes & fuel metabolism

Answer 23

fetal growth accelerates

placental hormones rise sharply

Question 24

GDM risk factors

Answer 24

overweight (BMI 26-29 or >29)
chronic HTN
maternal age >25
previous birth of large infant 
multifetal pregnancy
GDM in previous pregnancy

Question 25

One hour GTT (screen)

Answer 25

ingest 50g of oral glucose one hour later blood sample

Question 26

Positive 1 hr GTT

Answer 26

glucose >130-140

Question 27

3 hr glucose test (diagnostic)

Answer 27

fasting ingest 100g oral glucose glucose levels @ 1,2 & 3 hrs

Question 28

3 hr glucose dx

Answer 28

fasting >95 1 hr >180 2 hr >155 3 hr >140 if 2 or more values elevated

Question 29

testing @ 28 weeks testing @ 34 weeks

Answer 29

poor glycemic control good control

Question 30

HYPOglycemia s/s

Answer 30

``` nervousness headache weakness irritability hunger blurred vision ```

Question 31

HYPERglycemia s/s

Answer 31

``` Polydipsia polyuria polyphasia nausea abdominal p! flushed dry skin fruity breath ```